Healthcare Provider Details

I. General information

NPI: 1043122930
Provider Name (Legal Business Name): STEPHANIE BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7303 BRANCHWOOD TER
CLINTON MD
20735-2151
US

IV. Provider business mailing address

7303 BRANCHWOOD TER
CLINTON MD
20735-2151
US

V. Phone/Fax

Practice location:
  • Phone: 240-232-6332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: